scholarly journals Pathological Significance and Prognostic Roles of Indirect Bilirubin/Albumin Ratio in Hepatic Encephalopathy

2021 ◽  
Vol 8 ◽  
Author(s):  
Yanling Li ◽  
Huiyuan Liu ◽  
Keng Chen ◽  
Xueheng Wu ◽  
Jiawen Wu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Hepatic Encephalopathy ◽  
Protoporphyrin Ix ◽  
Heme Oxygenase 1 ◽  
Retrospective Case ◽  
Albumin Ratio ◽  
Indirect Bilirubin ◽  
New Strategy ◽  
History Of ◽  
Cerebellum Development

Background and Aim: Hepatic encephalopathy (HE) is a neurological disease caused by severe liver disease. Early identification of the risk factor is beneficial to the prevention and treatment of HE. Free bilirubin has always been considered to be the culprit of neonatal kernicterus, but there is no research to explore its role in HE. In this study, we aim to study the clinical significance of the indirect bilirubin-albumin ratio in HE.Methods: A retrospective case-control study of 204 patients with liver failure was conducted. Human serum albumin (HSA) or heme oxygenase-1 (HO-1) inhibitor SnPP (Tin protoporphyrin IX dichloride) was injected intraperitoneally into Ugt1−/− mice to establish a treatment model for endogenous hyperbilirubinemia.Results: IBil/albumin ratio (OR = 1.626, 95% CI1.323–2.000, P < 0.001), white blood cell (WBC) (OR = 1.128, 95% CI 1.009–1.262, P = 0.035), ammonia (OR = 1.010, 95% CI 1.001–1.019, P = 0.027), platelet (OR=1.008, 95% CI 1.001–1.016, P = 0.022), Hb (OR = 0.977, 95% CI 0.961–0.994, P = 0.007), and PTA (OR = 0.960, 95% CI 0.933–0.987, P = 0.005) were independent factors of HE. Patients with a history of liver cirrhosis and severe HE (OR = 12.323, 95% CI 3.278–47.076, P < 0.001) were more likely to die during hospitalization. HSA or SnPP treatment improved cerebellum development and reduced apoptosis of cerebellum cells.Conclusion: The IBil/albumin ratio constitutes the most powerful risk factor in the occurrence of HE, and reducing free bilirubin may be a new strategy for HE treatment.

Delirium and Right-Hemisphere Dysfunction in Cognitively Impaired Older Persons

1996 ◽  
Vol 8 (3) ◽  
pp. 373-382 ◽  
Author(s):  
John R. Mach ◽  
Vivian Kabat ◽  
Doug Olson ◽  
Michael Kuskowski
Keyword(s):  
Risk Factor ◽  
Right Hemisphere ◽  
Memory Loss ◽  
Depression Scale ◽  
Indirect Evidence ◽  
Controlled Study ◽  
Cognitively Impaired ◽  
Retrospective Case ◽  
Right Hemisphere Dysfunction ◽  
History Of

Cognitive impairment has been repeatedly shown to be a delirium risk factor. Much indirect evidence suggests that right-hemisphere dysfunction plays a particularly important role. This retrospective, case-controlled study, from a 148-patient memory loss clinic database, compared neuropsychological measures of hemispheric function in cognitively impaired elderly veterans with and without a history of delirium. Eleven study subjects had a history compatible with DSM-III-R criteria for delirium. Controls selected from the same database had no known history of delirium and were matched for Mini-Mental State Examination scores and Geriatric Depression Scale scores. Compared to the controls, subjects with a history of delirium had significantly lower scores on Object Assembly and Visual Reproduction (p < .05), tests that are predominantly right-hemisphere dependent. There were no significant differences in left-hemisphere measures. It is concluded that right-hemisphere dysfunction may prove to be an important risk factor for delirium.

Premorbid migraine history as a risk factor for vestibular and oculomotor baseline concussion assessment in pediatric athletes

2019 ◽  
Vol 23 (4) ◽  
pp. 465-470 ◽  
Author(s):  
Ryan N. Moran ◽  
Tracey Covassin ◽  
Jessica Wallace
Keyword(s):  
Risk Factor ◽  
Smooth Pursuit ◽  
Migraine Headache ◽  
Visual Motion ◽  
Assessment Tools ◽  
Motion Sensitivity ◽  
Ocular Reflex ◽  
Migraine Headaches ◽  
Vestibular Ocular Reflex ◽  
History Of

OBJECTIVEMigraine history has recently been identified as a risk factor for concussion and recovery. The authors performed a cross-sectional study examining baseline outcome measures on newly developed and implemented concussion assessment tools in pediatrics. The purpose of this study was to examine the effects of premorbid, diagnosed migraine headaches as a risk factor on vestibular and oculomotor baseline assessment in pediatric athletes.METHODSPediatric athletes between the ages of 8 and 14 years with a diagnosed history of migraine headache (n = 28) and matched controls without a history of diagnosed migraine headache (n = 28) were administered a baseline concussion assessment battery, consisting of the Vestibular/Ocular Motor Screening (VOMS), near point of convergence (NPC), and the King-Devick (K-D) tests. Between-groups comparisons were performed for vestibular symptoms and provocation scores on the VOMS (smooth pursuit, saccades, convergence, vestibular/ocular reflex, visual motion sensitivity), NPC (average distance), and K-D (time).RESULTSIndividuals diagnosed with migraine headaches reported greater VOMS smooth pursuit scores (p = 0.02), convergence scores (p = 0.04), vestibular ocular reflex scores (p value range 0.002–0.04), and visual motion sensitivity scores (p = 0.009). Differences were also observed on K-D oculomotor performance with worse times in those diagnosed with migraine headache (p = 0.02). No differences were reported on NPC distance (p = 0.06) or headache symptom reporting (p = 0.07) prior to the VOMS assessment.CONCLUSIONSPediatric athletes diagnosed with migraine headaches reported higher baseline symptom provocation scores on the VOMS. Athletes with migraine headaches also performed worse on the K-D test, further illustrating the influence of premorbid migraine headaches as a risk factor for elevated concussion assessment outcomes at baseline. Special consideration may be warranted for post-concussion assessment in athletes with migraine headaches.

History of Hepatic Encephalopathy is Not a Contraindication to TIPS Placement for Refractory Ascites

2020 ◽  
Author(s):  
Sammy Saab ◽  
Matthew Zhao ◽  
Ishan Asokan ◽  
Jung Jun Yum ◽  
Edward Wolfgang Lee
Keyword(s):  
Hepatic Encephalopathy ◽  
Refractory Ascites ◽  
History Of

scholarly journals Effects of Pregnancy Loss on Subsequent Postpartum Mental Health: A Prospective Longitudinal Cohort Study

2021 ◽  
Vol 18 (4) ◽  
pp. 2179
Author(s):  
David C. Reardon ◽  
Christopher Craver
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
Live Birth ◽  
Pregnancy Loss ◽  
Mental Health Problems ◽  
Psychiatric Treatment ◽  
Reproductive Services ◽  
History Of ◽  
Mental Health Treatments ◽  
Prospective Longitudinal

Pregnancy loss, natural or induced, is linked to higher rates of mental health problems, but little is known about its effects during the postpartum period. This study identifies the percentages of women receiving at least one postpartum psychiatric treatment (PPT), defined as any psychiatric treatment (ICD-9 290-316) within six months of their first live birth, relative to their history of pregnancy loss, history of prior mental health treatments, age, and race. The population consists of young women eligible for Medicaid in states that covered all reproductive services between 1999–2012. Of 1,939,078 Medicaid beneficiaries with a first live birth, 207,654 (10.7%) experienced at least one PPT, and 216,828 (11.2%) had at least one prior pregnancy loss. A history of prior mental health treatments (MHTs) was the strongest predictor of PPT, but a history of pregnancy loss is also another important risk factor. Overall, women with a prior pregnancy loss were 35% more likely to require a PPT. When the interactions of prior mental health and prior pregnancy loss are examined in greater detail, important effects of these combinations were revealed. About 58% of those whose first MHT was after a pregnancy loss required PPT. In addition, over 99% of women with a history of MHT one year prior to their first pregnancy loss required PPT after their first live births. These findings reveal that pregnancy loss (natural or induced) is a risk factor for PPT, and that the timing of events and the time span for considering prior mental health in research on pregnancy loss can significantly change observed effects. Clinicians should screen for a convergence of a history of MHT and prior pregnancy loss when evaluating pregnant women, in order to make appropriate referrals for counseling.

scholarly journals Patterns of Weight Change in Aging and Dying

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 491-491
Author(s):  
Stephen Thielke
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Risk Factor ◽  
Weight Change ◽  
Population Level ◽  
Chronological Age ◽  
Average Weight ◽  
Remaining Life ◽  
Entire Cohort ◽  
History Of

Abstract Little research has characterized the natural history of weight change in older adults. Different changes may occur during aging and dying. We analyzed 18 years of weight measures from a cohort of 736,361 Veterans, all of whom had died at age 70 or older. We produced summary measures that accounted for both chronological age and number of years before death. Several clear population-level trends appeared. (1) The average weight of the sample declined across all ages at a rate of about 0.18 BMI points per year. (2) Starting about seven years before death, the amount of loss began to accelerate, reaching a decline of 0.75 BMI points in the year before death. (3) Changes in weight relative to years of remaining life were independent of chronologic age. People who died at age 70 experienced, on average, the same type and duration of terminal decline as did those who died at age 95. (4) The dying process involved a cumulative loss of about 1.3 BMI points. (5) The distribution of weights during advancing age both declined and narrowed. (6) Disproportionate deaths occurred at the lower BMI ranges (below a BMI of 24), and especially below 18, regardless of age. (7) The finding in #5 is explained by the entire cohort losing weight, with death of the thinnest members. These findings argue for examining survival time in studies of weight change. They indicate that weight loss may be a natural part of dying, rather than a risk factor for it.

scholarly journals Bowel incarceration within the vaginal tunic in a three-and-half-year-old bilaterally cryptorchid Lhasa Apso

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Dorcas Oyueley Kodie ◽  
Noah Segun Oyetayo ◽  
Oladotun Solomon Awoyemi ◽  
Cecelia Omowunmi Oguntoye ◽  
Oghenemega David Eyarefe
Keyword(s):  
Risk Factor ◽  
Sertoli Cell ◽  
Epidural Anaesthesia ◽  
Spermatic Cord ◽  
Abdominal Cavity ◽  
Case Presentation ◽  
Spermatic Cord Torsion ◽  
Left Testicle ◽  
History Of ◽  
Sertoli Cell Tumours

Abstract Background Cryptorchidism in dogs is of clinical concern due to its association with development of Sertoli cell tumours, seminomas and spermatic cord torsion. A patent inguinal ring has been found as a risk factor for peritoneal content migration and inguinal hernias. This study reports a case of bowel migration through a patent inguinal ring in a bilaterally cryptorchid dog and incarceration within the vaginal tunic of the left testicle. Case presentation A three-and-a-half-year-old bilaterally cryptorchid Lhasa Apso with a history of anorexia, vomiting, stranguria and inability to defecate was diagnosed with bowel incarceration in the vaginal tunic of a retained left testicle. Surgery performed under epidural anaesthesia with acepromazine/butorphanol premedication revealed a loop of the colon entrapped in the vaginal tunic of the retained left testicle. The incarcerated bowel was thoroughly examined for viability and repositioned into the abdominal cavity. The inguinal ring was repaired and bilateral cryptorchidectomy performed. Conclusion Cryptorchidectomy in dogs is often considered when there is concern for neoplasm or torsion of retained testes. However, this report suggests that cryptorchidectomy should be considered also to preclude the possibility of bowel obstructive emergencies.

Gender Moderates the Association Between Exposure to Interpersonal Violence and Intermittent Explosive Disorder Diagnosis

2021 ◽  
pp. 088626052110139
Author(s):  
Lynette C. Krick ◽  
Mitchell E. Berman ◽  
Michael S. McCloskey ◽  
Emil F. Coccaro ◽  
Jennifer R. Fanning
Keyword(s):  
Risk Factor ◽  
Aggressive Behavior ◽  
Interpersonal Violence ◽  
Men And Women ◽  
Affective Dysregulation ◽  
Intermittent Explosive Disorder ◽  
The Family ◽  
History Of ◽  
Clinically Significant ◽  
The Relationship

Exposure to interpersonal violence (EIV) is a prevalent risk-factor for aggressive behavior; however, it is unclear whether the effect of EIV on clinically significant aggressive behavior is similar across gender. We examined whether gender moderates the association between experiencing and witnessing interpersonal violence and the diagnosis of intermittent explosive disorder (IED). We also examined potential pathways that might differentially account for the association between EIV and IED in men and women, including emotion regulation and social information processing (SIP). Adult men and women ( N = 582), who completed a semistructured clinical interview for syndromal and personality disorders, were classified as healthy controls (HC; n = 118), psychiatric controls (PC; n = 146) or participants with an IED diagnosis ( n = 318). Participants also completed the life history of experienced aggression (LHEA) and life history of witnessed aggression (Lhwa) structured interview and self-report measures of emotion regulation and SIP. Men reported more EIV over the lifetime. In multiple logistic regression analysis, experiencing and witnessing aggression within the family and experiencing aggression outside the family were associated with lifetime IED diagnosis. We found that the relationship between EIV and IED was stronger in women than in men. Affective dysregulation mediated certain forms of EIV, and this relation was observed in both men and women. SIP biases did not mediate the relation between EIV and IED. EIV across the lifespan is a robust risk factor for recurrent, clinically significant aggressive behavior (i.e., IED). However, the relationship between EIV and IED appears to be stronger in women. Further, this relation appears partially mediated by affective dysregulation.

scholarly journals Incidence and Risk Factors of Symptomatic Venous Thromboembolism Following Foot and Ankle Surgery

2018 ◽  
Vol 40 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Johanna Marie Richey ◽  
Miranda Lucia Ritterman Weintraub ◽  
John M. Schuberth
Keyword(s):  
Risk Factors ◽  
Hormone Replacement ◽  
Case Series ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
History Of ◽  
Low Incidence ◽  
Predictive Risk

Background: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. Methods: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. Results: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). Conclusion: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. Level of Evidence: Level III, retrospective case series.

HISTORY OF SUNLIGHT EXPOSURE IS A RISK FACTOR FOR AGE-RELATED MACULAR DEGENERATION

Retina ◽  
2016 ◽  
Vol 36 (4) ◽  
pp. 787-790 ◽  
Author(s):  
Tina Schick ◽  
Lebriz Ersoy ◽  
Yara T. E. Lechanteur ◽  
Nicole T. M. Saksens ◽  
Carel B. Hoyng ◽  
...  
Keyword(s):  
Risk Factor ◽  
Macular Degeneration ◽  
Sunlight Exposure ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
History Of
Sign in / Sign up

Export Citation Format

Share Document